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Sunday, March 21, 2010
Grand Hall (Hyatt Regency Atlanta)
Background: In Korea, it was not until the founding of the Korean Society for Nosocomial Infection Control (KOSNIC) in November 1995 that organized activities for surveillance of nosocomial infections (NIs) first occurred. In January 2006, KOSNIC organized the Korean Nosocomial Infections Surveillance System (KONIS) to establish a nationwide database of NI rates in the ICUs of Korean hospitals. From January through June 2006, the KONIS Steering Committee made a consensus of standardized practices for surveillance that was summarized in the KONIS manual. KONIS began on 1 July 2006, with data being collected using an Internet-based data entry interface (KONIS Web-based Report and Analysis Program, KONIS WRAP, http://konis.cdc.go.kr).
Objective: KONIS is the first nationwide surveillance system having been implemented in Korea. We analyzed the trend of device-associated hospital-acquired infections for first 3 years.
Methods: The committee of KONIS conducted prospective surveillance: urinary tract infection (UTI), bloodstream infection (BSI), and pneumonia. All investigators were trained and validated in detecting and diagnosing NIs according to the definitions of Center for Disease Control and Prevention (CDC). Investigators of KONIS member hospitals should input patient-days and device-days monthly on the internet. And they report the data of nosocomial infection cases into a form, which consists of demographic data, admission date, infection date, and type of infections. Device-associated NI rates per 1000 device-days and device utilization ratios were presented on KONIS WRAP, and the 95% confidence intervals of rates and ratios were also calculated.
Results: Since a total of 76 ICUs at 44 hospitals participated voluntarily from July 2006 through June 2007 in KONIS, a total of 101 ICUs at 57 hospitals with more than 300 beds evenly participated for four quarters from July 2008 through June 2009. We observed from 143,384 urinary catheter-days, 94,033 central line-days, and 57,754 ventilator-days in first year, to 369,476 urinary catheter-days, 243,882 central line-days, and 179,803 ventilator-days in third year. Comparing the annual data each other since 2006 showed that ventilator-associated pneumonia decreased significantly from 3.68 [95% CI; 3.25-4.17] to 1.86 [95% CI; 1.67-2.07] per 1,000 device-days. Catheter-associated UTI and catheter-associated BSI rate, however, has not significantly changed during the same period; from 4.24 [95% CI; 3.92-4.59] to 4.8 [95% CI; 4.58-5.03], from 3.17 [95% CI; 2.83-3.55] to 3.27 [95% CI; 3.05-3.51] per 1,000 device-days, respectively.
Objective: KONIS is the first nationwide surveillance system having been implemented in Korea. We analyzed the trend of device-associated hospital-acquired infections for first 3 years.
Methods: The committee of KONIS conducted prospective surveillance: urinary tract infection (UTI), bloodstream infection (BSI), and pneumonia. All investigators were trained and validated in detecting and diagnosing NIs according to the definitions of Center for Disease Control and Prevention (CDC). Investigators of KONIS member hospitals should input patient-days and device-days monthly on the internet. And they report the data of nosocomial infection cases into a form, which consists of demographic data, admission date, infection date, and type of infections. Device-associated NI rates per 1000 device-days and device utilization ratios were presented on KONIS WRAP, and the 95% confidence intervals of rates and ratios were also calculated.
Results: Since a total of 76 ICUs at 44 hospitals participated voluntarily from July 2006 through June 2007 in KONIS, a total of 101 ICUs at 57 hospitals with more than 300 beds evenly participated for four quarters from July 2008 through June 2009. We observed from 143,384 urinary catheter-days, 94,033 central line-days, and 57,754 ventilator-days in first year, to 369,476 urinary catheter-days, 243,882 central line-days, and 179,803 ventilator-days in third year. Comparing the annual data each other since 2006 showed that ventilator-associated pneumonia decreased significantly from 3.68 [95% CI; 3.25-4.17] to 1.86 [95% CI; 1.67-2.07] per 1,000 device-days. Catheter-associated UTI and catheter-associated BSI rate, however, has not significantly changed during the same period; from 4.24 [95% CI; 3.92-4.59] to 4.8 [95% CI; 4.58-5.03], from 3.17 [95% CI; 2.83-3.55] to 3.27 [95% CI; 3.05-3.51] per 1,000 device-days, respectively.
Conclusions: The KONIS was established and started only recently, so more efforts would be made for maintaining steadily and getting a long time outcome.